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• CLINICA NEUROL, 47: 47−49, 2007
• Vol.47 No.1 contents

Case Report

A sixty-year-old man suffering from multiple system atrophy with pneumatosis intestinalis

Fumitaka Shimizu, M.D., Motoharu Kawai, M.D., Jun-ichi Ogasawara, M.D., Kiyoshi Negoro, M.D. and Takashi Kanda, M.D.

Department of Neurology and Clinical Neuroscience, Yamaguchi University Graduate School of Medicine

We herein report a 60-year-old man demonstrating multiple system atrophy of the cerebellar type (MSA-C) with a five-year of clinical history, who developed severe constipation followed by watery diarrhea. An abdominal CT scan showed free air in the abdominal cavity and extensive pericolic gas accumulation in the ascending and transverse colon. He was diagnosed to have pneumatosis intestinalis (PI). The air in the abdominal cavity as well as in the wall of the colon thereafter disappeared after nine days' of conservative therapy. The presense of chronic idiopathic intestinal pseudo-obstruction due to severe dysautonomia and a longstanding bed-ridden state may have been the cause of PI in this patient. This is the first case report of PI associated with MSA; however, the association of PI may have been overlooked in this disorder because of severe constipation and diarrhea, the two cardinal symptoms of PI, which happen to also be two of the typical symptoms of MSA itself.

(CLINICA NEUROL, 47: 47−49, 2007)
key words: pneumatosis intestinalis, multiple system atrophy, chronic idiopathic intestinal pseudoobstruction

(Received: 14-Sep-06)